Nana’s Notes:

Went to oncology this morning for radiation mapping and to see chemo doctor.  

Chemo doctor explained chemo treatment.  Not very encouraging.  Lots of fatigue and could decrease bone marrow & platelets.

We will start it next week & see how it goes.  Even one month of treatment could help.

When we returned to rehab this afternoon, we found out Papa’s diet was upgraded to a soft diet & thin liquids.  He was excited.

Had physical therapy session.

Kari & I discouraged about results of chemo consult.

Text: (from me to J’s step-mom)

Was impressed w/ dr.  She was very upfront about risks/life expectancy, etc.  Lots to think about, but most likely will proceed w/ treatment.

My Reflections:

Papa has another appointment at the cancer center where we previously met with the radiation doc (oncologist if we want to get all fancy and technical).  This time we’ll meet with the chemo oncologist and then Papa will have his skull mapped for where they’ll be administering radiation (they’ ll be targeting the area where his tumor was located in an effort to kill off any residual cancer cells and hold off tumor regrowth for as long as possible).

When we see the chemo doc today, her tune is far different than the radiation doc’s was during our last appointment here.  As she discusses the recommended chemo treatment, she doesn’t beat around the bush with the risks and side affects involved.  She doesn’t come across as a pessimist, but more as a realist.  She lets us know that considering Papa’s pre-existing heart condition, his age, and his current weakness, the chemo drugs will be hard on him, and he’ll be at a far greater risk for contracting other conditions that can result from the drugs weakening his immune system, especially PCP, a form of pneumonia.  They will give him other drugs to help counteract this risk, but she can’t guarantee his quality of life will be good or how much more life he’ll gain for putting him through the rigors of chemo.  As she speaks, the mood is sombre.  We sit there, trying to take it all in.  I blink back tears and ask my questions, Papa & Nana ask their’s, we try to understand all that’s involved.

As hard as it is to hear some of what the doctor is telling us, hearing how this treatment decision is far from easy or clear-cut, in a way it’s refreshing to be told the “real deal” with no sugar-coating involved.  I appreciate the doctor’s honesty, making us aware of what’s possibly to come.  She doesn’t speak these words coldly, but rather with sincere concern; we can visibly see the concern in her eyes as she speaks.  I truly believe she cares more about Papa as a person than him as a potential patient to add to her roster.

There’s lots to consider before decisions are made, but with our questions asked and the doctor’s info given, the doctor moves onto her next appointment and Papa is wheeled away by a nurse for his skull-mapping.  I say a quick goodbye to Nana in the hall before heading out to pick up the boys from a friends’.  There are tears in Nana’s eyes and this time she is the one who’s left shaken.  Up to this point she’s been the strong one, taking all this cancer business in stride.  While I’ve been researching and googling from the beginning, needing to know just how bad this anaplastic astrocytoma business can get, Nana’s chosen to take the one-day-at-a-time approach, not looking too far beyond the present.  I can’t blame her for that.  Yet now, after meeting with the most frank doctor we’ve met with thus far, I believe the brevity of Papa’s condition, his expected life-span, and the bleakness of treatment options are finally setting in.  It’s hard to to see Nana so rattled.  It’s hard to know what to say.  We’re standing there in a middle of a cancer center hallway and she needs to go with Papa and I need to pick up the boys, so we say our goodbyes and say we’ll discuss this all later.

So I depart, not quite sure what Papa will decide.  Not quite sure what I would do if it were me in Papa’s shoes.

It’s a lot to take in.

(quote and composition by Mark)